WHO mental health report cites lack of facility, training

A report from the World Health Organization cites the lack of a national mental health policy and a shortage of beds for psychiatric patients as weaknesses in Cayman’s health system.

The report, however, points to progress on the Mental Health Commission and access to outpatient care as strengths in the system.

Issues with psychiatric care in the Cayman Islands have come to the fore recently as the Mental Health Commission prepares a report for government on the proposed mental health hospital. Commission chair Dr. Marc Lockhart said he expects to deliver the proposal to cabinet within the next two weeks.

Cayman, Dr. Lockhart said, has been working on reforming its mental health system since the early 2000s.

“We do need to speed the process up,” he said, but pointed to progress in several areas, including the opening of the mental health unit at the Cayman Islands hospital in 2003, the drug and mental health courts that started in 2011, and the 2013 Mental Health Law that established the commission.

The report, he said, is the first time Cayman has had clear information on the state of mental healthcare in the country. Dr. Lockhart said, “The report confirms what we’ve been seeing for year.”

The report documents eight weaknesses in Cayman’s mental health system: the lack of a mental health policy, the limited number of mental health beds and none available for children and adolescents, and a shortage of mental health professionals, especially for children. It states that there’s not enough training for doctors and nurses for dealing with children with mental health problems.

The report cites the need for a residential facility in Cayman for people with mental illness, and more training on human rights for mentally ill people, not enough oversight of doctors prescribing psychotropic drugs, and a lack of data from the Health Services Authority

The Health Services Authority did not respond to a request for comment on the report, but the Ministry of Health released a statement along with the report, responding to the weaknesses. In the release, Health Ministry officials write that most of the concerns in the report will be covered by either the anticipated Mental Health Policy or by creating a new residential facility.

The ministry response states, “The government has recognized the need for such a facility and as such the Ministry of Health is about to convene the Steering Committee to develop the first long-term residential mental health facility for the Cayman Islands.”

The ministry says there is funding in the next fiscal year to begin the process by putting out a request for proposals for an outline business case for the facility.

Commission chair Dr. Lockhart said that once the new facility is operational, some of the existing beds in the hospital could be partitioned off to serve children and adolescents. He noted that there is no need for two facilities, one for adults and the other for children, because Cayman does not need many beds for kids suffering from mental illness.

He said government ministries need to coordinate and work together more to move mental healthcare forward and not duplicate efforts. “If we’re a ship, we need all hands on deck,” he said.

He said some are critical of the slow progress being made on mental health reform, as successive governments have set up task forces and done studies that seem to disappear on a shelf somewhere in the Ministry of Health.

He agreed that reform needed to move faster. But, he said, the recent progress was laid out in a 2010 task force report that, he added, “We’ve followed systematically.”

The Mental Health Commission asked the WHO to perform the study, which was completed last year but only now released to the public. “This was not a wasted exercise,” Dr. Lockhart said, noting, “This is not a study to push the ball down the road.”

Dr. Lockhart

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